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ASSESSING THE LONG-TERM PRIORITIES AND QUALITY OF LIFE OF PANCREATICODUODENECTOMY SURVIVORS
Edward A. Joseph
*, Kara Bowers, Rebecca Marcus, Bibek Aryal, Suzanne Schiffman, Patrick Wagner, Sricharan Chalikonda, David Bartlett, Casey Allen
Surgical Oncology , Allegheny Health Network, Pittsburgh, PA
IntroductionPancreaticoduodenectomy (PD) has a significant impact on patients' quality of life. Recognizing patients' priorities can help guide patient-centric care. This study assessed the long-term quality of life (QOL) and priorities of PD survivors.
Methods PD survivors were surveyed via internet-based support groups. Questions addressed how patients ranked priorities such as longevity, costs, experience, and functional and emotional well-being. Using the Short Form-12 questionnaire, health-related QOL in both physical (P-QOL) and mental (M-QOL) domains were compared to that of the general population. Factors such as the presence of malignant disease and survival duration (short-term vs long-term) were evaluated in relation to patients' QOL and priorities.
ResultsThe PD cohort (n=247, 35%) was 60±12 years, 71% female, and 93% white. With moderate agreement, patients ranked survival most important, followed by functional and emotional well-being; costs and experience were least important (W=35.7%, p<0.001). Well-being improved throughout survivorship (P-QOL: 39±12 at ≤3 mo vs 43±12 at >10 y, p=0.17; M-QOL: 38±13 at ≤3 mo vs 44±16 at >10 y; p=0.015) but remained below the general population (p<0.001). PD patients with benign diagnoses ranked functional independence as most important (2.00±1.13 vs 2.63±1.19, p<0.001, W=41.1%); PD patients with malignant diagnoses regarded overall survival most important (2.10±1.20 vs 1.82±1.22, p<0.16, W=35.1%). The mean rank order of priorities remained concordant between short-term (<1 year) and long-term (>5 years) survivors.
Outcomes PD survivors experience long-term mental and physical health impairments, underscoring the importance of functional and emotional support. Survivors place paramount importance on overall survival, functional independence, and emotional well-being. Cancer survivors prioritize longevity, while survivors of chronic benign conditions prioritize functional independence.
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